Benefits Bulletin 2019 2020

2019 - 2020











BENEFITS










BULLETIN













Enrollment Period



July 22 - August 16, 2019









The Clear Creek ISD Annual Enrollment Period opens Monday,
July 22 and ends Friday, August 16, 2019. This is the one
time per year when you can enroll, change or cancel your

benefits without a life event. Do not miss this opportunity.
The Benefits Hub Enrollment system will be available to all
eligible employees via the Internet 24 hours a day, 7 days a
week, during the enrollment period. All new enrollments and
changes made during this Enrollment Period will be effective
September 1, 2019, or the first of the month following

insurance company approval (life insurance, cancer and
specified disease), whichever is later. While this enrollment is
considered passive, meaning your insurance coverage will roll
forward to the new benefit year if you do nothing, we
encourage you to log on to the new system and confirm
your benefits coverage, reload your flexible spending
accounts, and set-up life insurance beneficiaries.

BENEFITS HUB








Online Enrollment System Available July 22, 2019


To enroll, make changes or cancel your coverage:
Visit: www.mybenefitshub.com/clearcreekisd

Please use your CCISD network credentials to log in.

Problems logging in? Please contact the Help Desk at (281) 284-4357
during regular business hours or visit @work on the CCISD website for
password assistance.



What's New for 2019-2020 Benefits



TRS ActiveCare 2 Plan: The TRS ActiveCare 2 plan remains closed to
new enrollment. Employees currently enrolled in the plan for the
2018-2019 plan year may remain on the plan and enroll new
dependents during Open Enrollment. The in-network out of pocket
maximum is increasing to $7,900 for individual and $15,800 for family
coverage.

Prescription coverage/Preferred brand drugs: Participants will
pay 25% after the drug deductible.

TRS ActiveCare 1-HD Plan: The in-network out of pocket maximum is increasing to $6,750 for
employee only coverage and $13,500 for employee + dependent coverage.

Prescription coverage/Preferred brand drugs: Participants will pay 25% after the deductible.

TRS ActiveCare Select Plan: The in-network out of pocket maximum is increasing to $7,900 for
employee only coverage and $15,800 for employee + dependent coverage.

Prescription coverage/Generic drugs: Participants will pay $15, down from $20.

Prescription coverage/Preferred brand drugs: Participants will pay 25% after the drug deductible.

The Allstate Cancer plan will be guaranteed issue during this year’s Open Enrollment period. This
provides employees and their eligible dependents an opportunity to enroll in the benefit without
having to go through the Evidence of Insurability process.

CCISD’s Critical Illness carrier is changing from Allstate to Aetna. More details about this benefit can be
found at www.mybenefitshub.com/clearcreekisd.

CCISD’s Accident Plan and Hospital Plan carrier is changing from Metlife to Aetna. More details about
this benefit can be found at www.mybenefitshub.com/clearcreekisd.
1

PLAN CHANGES








Participants in the TRS ActiveCare 1-HD Plan
Must Now Choose a Primary Care Physician


Beginning in the 2019-2020 plan year, employees enrolled in ActiveCare
1-HD must choose a primary care physician for all participants on the
plan during the Open Enrollment period. A primary care physician (PCP)
can be a general practitioner, an internal medicine doctor, or a
pediatrician. Although employees are electing a PCP, they are free to see
other physicians.

If employees do not choose a PCP during Open Enrollment, Aetna will
select one for each plan participant based on providers that were seen in
the past. If the participant has not seen a PCP within the last 18 months,
one will be selected for them based on a recommendation by Aetna. If
employees wish to change their PCP election, they can do so by logging
into www.trsactivecareaetna.com or calling TRS ActiveCare Customer
Service at 800-222-9205.

All TRS AC 1-HD plan participants will receive a new ID card in the mail
with their primary care physician listed on the card. Enrollments
finalized by August 8 will receive a new card in the mail by September 1.

All employees may enroll in AC 1-HD which has an open access network
of providers. Employees interested in enrolling in AC Select may use the
following chart to determine plan eligibility:



If you live in the following counties: TRS-ActiveCare Select Whole Health:


Ft. Bend, Harris, Montgomery, Galveston and part of Brazoria* Kelsey Select

Memorial Hermann Accountable Care
Brazoria*, Ft. Bend, Galveston**, Harris and Montgomery
Network

*Brazoria zip codes: 77511, 77512, 77578, 77581, 77583, 77584 and 77588
**Galveston zip codes: 77539, 77546, 77549, 77565, 77573, 77574


Open Enrollment Tips TO FIND TRS-ACTIVECARE PARTICIPATING

PROVIDERS:
Before enrolling in a TRS-ActiveCare Health Plan,
employees should determine whether their preferred • Visit: www.trsactivecareaetna.com
providers accept the plan they are considering. The • Select: Find a Doctor or Facility
TRS-ActiveCare Insurance website at
www.trsactivecareaetna.com enables employees to Follow the instructions on screen to locate providers
"Find a Doctor or Facility" that accepts the various that accept the various TRS-ActiveCare Insurance
plans. Employees should also confirm their findings Plans. Make certain you search for the correct Select
by contacting their providers directly. plan based on where you live. 1

MID-YEAR CHANGES










Employees enrolling or making changes in their elections during the
annual open enrollment period should be aware that they cannot make
changes during the benefit plan year, September 1, 2019 through August
31, 2020, unless they have a "Special Enrollment Event." Some examples
of special enrollment events are below:

Change in Marital Status: Marriage or divorce
Newly Eligible Dependents: Birth, adoption, foster care placement
Loss or Gain of Other Coverage: Change in your spouse's employment
status that results in a loss or gain of coverage or loss or gain of
Medicaid coverage.
Acquiring Other Coverage: Change in your spouse's employment
status that results in your gaining coverage, or acquiring other
coverage during a spouse's Annual Enrollment Period.
A change in your dependent's eligibility status due to age: Coverage
ends the last day of the month of a child's 26th birthday.


SPECIAL NOTE: Any changes outlined above must be made within thirty
one (31) days of the change of status event date and must be evidenced
at the time of the change with documented proof of the change. If in
doubt as to whether an event qualifies for a change in elections or what is
accepted as documentation of the status change, please call the Business
Services Department for assistance well in advance of the thirty one (31)
calendar day deadline. For most special enrollment events, the effective
date of coverage will be the first of the month after the event date. Any
termination of your coverage will be effective the last day of the month in
which you submit the cancellation request.






Clear Creek ISD Offers Medical Insurance to


Eligible Substitutes and Part-Time Employees



All employees that are actively contributing to TRS, regardless of number of

hours worked, and all substitute employees working 10 or more hours per week
are eligible to enroll in the 2019 - 2020 TRS-ActiveCare Health Insurance plans
during the upcoming open enrollment period. Substitutes can enroll by
completing the Health Insurance Notice in the 2019 - 2020 Returning Substitute
Checklist in TalentEd. Once this is completed, substitutes should then go to
www.mybenefitshub.com/clearcreekisd to enroll during the open
enrollment.

OPEN ENROLLMENT







ASSISTANCE









Get Answers to Your Questions and Obtain Enrollment

Assistance by Attending an Open Enrollment Meeting





Monday, July 29 8 a.m. - 4 p.m.


Thursday, August 1 8 a.m. - 4 p.m.

Monday, August 5 8 a.m. - 4 p.m.


Thursday, August 8 8 a.m. - 4 p.m.

Monday, August 12 - Friday, August 16 1 p.m. - 6 p.m.






SESSIONS WILL BE HELD AT:

Clear Path Alternative Education Center
1001 Magnolia Ave

Webster, TX 77598








Required: Employees Choosing Not to

Enroll in TRS-ActiveCare Must "Waive"

(Decline) Coverage Every Year





In compliance with Affordable Care Act regulations, all CCISD employees
eligible for medical insurance are required to enroll in one of the TRS-
ActiveCare health plans or waive (decline) the coverage in the Benefits Hub
Enrollment System. The waiver must be submitted each year even if the
coverage was waived previously.

2019-20 TRS ActiveCare Plan Highlights
-

Effective Sept. 1, 2019 through Aug. 31, 2020 | In-Network Level of Benefits 1



Medical Coverage TRS-ActiveCare 1-HD TRS-ActiveCare Select or TRS-ActiveCare 2
TRS-ActiveCare Select Whole Health
(Baptist Health System and HealthTexas Medical NOTE: If you’re currently enrolled in TRS-ActiveCare 2,
Group; Baylor Scott and White Quality Alliance; you can remain in this plan. However, as of
Kelsey Select; Memorial Hermann Accountable Sept. 1, 2018, TRS-ActiveCare 2 is closed to
Care Network; Seton Health Alliance) new enrollees.
Deductible
(per plan year)
In-Network $2,750 employee only/$5,500 family $1,200 individual/$3,600 family $1,000 individual/$3,000 family
Out-of-Network $5,500 employee only/$11,000 family Not applicable. This plan does not cover out- $2,000 individual/$6,000 family
of-network services except for emergencies.
Out-of-Pocket Maximum The individual out-of-pocket maximum
(per plan year; medical and prescription drug only includes covered expenses incurred
deductibles, copays, and coinsurance count by that individual.
toward the out-of-pocket maximum)
In-Network $6,750 individual/$13,500 family $7,900 individual/$15,800 family $7,900 individual/$15,800 family
Out-of-Network $20,250 individual/$40,500 family Not applicable. This plan does not cover out- $23,700 individual/$47,400 family
of-network services except for emergencies.
Coinsurance
In-Network Participant pays (after deductible) 20% 20% 20%
Out-of-Network Participant pays 40% of allowed amount unless otherwise Not applicable. This plan does not cover out- 40% of allowed amount unless
(after deductible) noted of-network services except for emergencies. otherwise noted
Office Visit Copay 20% after deductible $30 copay for primary $30 copay for primary
Participant pays $70 copay for specialist $70 copay for specialist
Diagnostic Lab 20% after deductible 20% after deductible 20% after deductible
Participant pays
Preventive Care Plan pays 100% Plan pays 100% Plan pays 100%
See below for examples
Teladoc® Physician Services $40 consultation fee (counts toward Plan pays 100% Plan pays 100%
deductible and out-of-pocket maximum)
High-Tech Radiology 20% after deductible $100 copay plus 20% after deductible $100 copay plus 20% after deductible
(CT scan, MRI, nuclear medicine) Participant pays
Inpatient Hospital Facility Charges Only
(preauthorization required)
In-Network 20% after deductible $150 copay per day plus 20% after $150 copay per day plus 20% after deductible
deductible ($750 maximum copay per ($750 maximum copay per admission; $2,250
admission) maximum copay per plan year)
Out-of-Network Plan pays up to $500 per day cap of Not applicable. This plan does not cover out- Plan pays up to $500 per day cap of covered
covered charges after deductible; you pay of-network services except for emergencies. charges after deductible; you pay the excess
the excess over the $500 per day cap of over the $500 per day cap
Urgent Care 20% after deductible $50 copay per visit $50 copay per visit
Freestanding Emergency Room $500 copay per visit plus 20% after $500 copay per visit plus 20% after $500 copay per visit plus 20% after
Participant pays deductible deductible deductible
Emergency Room (true emergency use) 20% after deductible $250 copay plus 20% after deductible $250 copay plus 20% after deductible
Participant pays (copay waived if admitted) (copay waived if admitted)
Outpatient Surgery 20% after deductible $150 copay per visit plus 20% after $150 copay per visit plus 20% after
Participant pays deductible deductible
Bariatric Surgery $5,000 copay (does apply to out-of- Not covered $5,000 copay (does not apply to
(only covered if performed at an IOQ facility) pocket maximum) plus 20% after out-of-pocket maximum) plus 20%
Physician charges; Participant pays deductible after deductible
Annual Vision Examination 20% after deductible $70 copay for specialist $70 copay for specialist
(one per plan year; performed by an ophthalmologist
or optometrist) Participant pays
Annual Hearing Examination 20% after deductible $30 copay for primary $30 copay for primary
Participant pays $70 copay for specialist $70 copay for specialist
Preventive Care
Some examples of preventive care frequency and services:
• Routine physicals – annually age 12 and over • Well-child care – unlimited up to age 12 • Well woman exam & pap smear – annually age 18 and over
• Mammograms – one every year age 35 and over • Colonoscopy – one every 10 years age 50 and over • Prostate cancer screening – one per year age 50 and over
• Smoking cessation counseling – eight visits per 12 months • Healthy diet/obesity counseling – unlimited to • Breastfeeding support – six lactation counseling visits
age 22; age 22 and over – 26 visits per 12 months per 12 months
Note: Covered services under this benefit must be billed by the provider as “preventive care.” Non-network preventive care is not paid at 100%. If you receive preventive services from a non-network provider,
you will be responsible for any applicable deductible and coinsurance under the TRS-ActiveCare 1-HD and TRS-ActiveCare 2. There is no coverage for non-network services under the TRS-ActiveCare Select plan
or TRS-ActiveCare Select Whole Health. For more information, please view the Benefits Booklet at www.trsactivecareaetna.com.
TRS-ActiveCare is administered by Aetna Life Insurance Company. Aetna provides claims payment services only and does not assume any financial risk or obligation with respect to claims. Prescription drug
benefits are administered by Caremark.

2019-20 TRS ActiveCare Plan Highlights
-





Prescription TRS-ActiveCare 1-HD TRS-ActiveCare Select or ActiveCare TRS-ActiveCare 2
Coverage Select Whole Health NOTE: If you’re currently enrolled in TRS-ActiveCare 2,
(Baptist Health System and HealthTexas Medical
Group; Baylor Scott and White Quality Alliance; you can remain in this plan. However, as of
Kelsey Select; Memorial Hermann Accountable Sept. 1, 2018, TRS-ActiveCare 2 is closed to
Care Network; Seton Health Alliance) new enrollees.
Drug Deductible Must meet plan-year deductible $0 generic; $200 brand $0 generic; $200 brand
(per person, per plan year) before plan pays. 2
Short-Term Supply at a Retail Location (up to a 31-day supply)
Tier 1 – Generic 20% coinsurance after deductible, $15 copay $20 copay
except for certain generic preventive
drugs that are covered at 100%. 2
Tier 2 – Preferred Brand 25% coinsurance after deductible 3 25% coinsurance (min. $40 ; max. $80) 3 25% coinsurance (min. $40 ; max. $80) 3
4
4
Tier 3 – Non-Preferred Brand 50% coinsurance after deductible 3 50% coinsurance 3 50% coinsurance (min. $100 ; max. $200) 3
4
Extended-Day Supply at Mail Order or Retail-Plus Pharmacy Location (60- to 90-day supply) 5
Tier 1 – Generic 20% coinsurance after deductible $45 copay $45 copay
Tier 2 – Preferred Brand 25% coinsurance after deductible 3 25% coinsurance (min. $105 ; max. $210) 3 25% coinsurance (min. $105 ; max. $210) 3
4
4
Tier 3 – Non-Preferred Brand 50% coinsurance after deductible 3 50% coinsurance 3 50% coinsurance (min. $215 ; max. $430) 3
4
Specialty Medications (up to a 31-day supply)
Specialty Medications 20% coinsurance after deductible 20% coinsurance 20% coinsurance (min. $200 ; max. $900)
4
Short-Term Supply of a Maintenance Medication at Retail Location up to a 31-day supply
The second time a participant fills a short-term supply of a maintenance medication at a retail pharmacy, they will be charged the coinsurance and copays in the
rows below. Participants can save more over the plan year by filling a larger day supply of a maintenance medication through mail order or at a Retail-Plus location.
Tier 1 – Generic 20% coinsurance after deductible $30 copay $35 copay
Tier 2 – Preferred Brand 25% coinsurance after deductible 3 25% coinsurance (min. $60 ; max. $120) 3 25% coinsurance (min. $60 ; max. $120) 3
4
4
Tier 3 – Non-Preferred Brand 50% coinsurance after deductible 3 50% coinsurance 3 50% coinsurance (min. $105 ; max. $210) 3
4
What is a maintenance medication?
Maintenance medications are prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually
require regular, daily use of medicines. Examples of maintenance drugs are those used to treat high blood pressure, heart disease, asthma and diabetes.
When does the convenience fee apply?
For example, if you are covered under TRS-ActiveCare Select, the first time you fill a 31-day supply of a generic maintenance drug at a retail pharmacy
you will pay $15, then you will pay $30 each month that you fill a 31-day supply of that generic maintenance drug at a retail pharmacy. A 90-day
supply of that same generic maintenance medication would cost $45, and you would save $180 over the year by filling a 90-day supply.
A specialist is any physician other than family practitioner, internist, OB/GYN or pediatrician.
1 Illustrates benefits when in-network providers are used. For some plans non-network benefits are also available; there is no coverage for non-network benefits under the
TRS-ActiveCare Select or TRS-ActiveCare Select Whole Health Plan; see Enrollment Guide for more information. Non-contracting providers may bill for amounts exceeding
the allowable amount for covered services. Participants will be responsible for this balance bill amount, which maybe considerable.
2 For TRS-ActiveCare 1-HD, certain generic preventive drugs are covered at 100%. Participants do not have to meet the deductible ($2,750 – individual, $5,500 – family)
and they pay nothing out of pocket for these drugs. Find the list of drugs at info.caremark.com/trsactivecare.
3 If a participant obtains a brand-name drug when a generic equivalent is available, they are responsible for the generic copay plus the cost difference between the
brand-name drug and the generic drug.
4 If the cost of the drug is less than the minimum, you will pay the cost of the drug.
5 Participants can fill 32-day to 90-day supply through mail order.

Monthly Premiums
TRS-ActiveCare TRS-ActiveCare 1-HD TRS-ActiveCare Select/ TRS-ActiveCare 2
Monthly ActiveCare Select Whole Health
Premium Full monthly Premium with Your monthly Full monthly Premium with Your monthly Full monthly Premium with Your monthly
premium* min. state/district premium*** premium* min. state/district premium*** premium* min. state/district premium***
contribution** contribution** contribution**
Individual $68 $246 $542
+Spouse $696 $997 $1,650
+Children $377 $557 $922
+Family $1,020 $1,323 $1,994

* If you are not eligible for the state/district subsidy, you will pay the full monthly premium. Please contact your Benefits Administrator for your monthly premium.
** The premium after state, $75 and district, $150 contribution is the maximum you may pay per month. Ask your Benefits Administrator for your monthly cost.
(This is the amount you will owe each month after all available subsidies are applied to your premium.)
*** Completed by your benefits administrator. The state/district contribution may be greater than $225.



TRSAC-0097 (4/19)

PREMIUM RATES










Clear Creek ISD Employee
Monthly Premium Rates 2019-2020



Monthly Employee Premium Per
Plan Name Employee Check
Premium

ActiveCare 1-HD


Employee Only $68.00 $34.00

Employee + Spouse $696.00 $348.00

Employee + Child(ren) $377.00 $188.50

Employee + Family $1,020.00 $510.00


ActiveCare2

Employee Only $542.00 $271.00

Employee + Spouse $1,650.00 $825.00

Employee + Child(ren) $922.00 $461.00

Employee + Family $1,994.00 $997.00


ActiveCare Select

Employee Only $246.00 $123.00

Employee + Spouse $997.00 $498.50

Employee + Child(ren) $557.00 $278.50

Employee + Family $1,323.00 $661.50




Enrollment Deadline




All new enrollments, changes and cancellations must be made no later than
Friday, August 16, 2019. If you are changing medical plans and want your AETNA ID
card by September 1, 2019, please enroll by August 9, 2019. If you would like your

HSA Bank card by September 1, 2019, please enroll by August 2, 2019. All Evidence of
Insurability forms for Optional Life Insurance will be emailed to the plan participant's CCISD email address
following Open Enrollment. Forms must be completed online no later than Friday, August 30, 2019.

PREMIUM RATES












Substitute Monthly Premium Rates


TRS ActiveCare 1- TRS ActiveCare TRS ActiveCare
Substitute (10+ hrs)
HD Select 2

Employee Only $378 $556 $852

Employee + Child(ren) $722 $902 $1,267

Employee + Spouse $1,066 $1,367 $2,020

Employee + Family $1,415 $1,718 $2,389





Employee Monthly Rates - Other Benefits


Aetna Dental Aetna Dental PPO Superior Vision Plan
DHMO

Employee Only $0 $15 $9.14

Employee +
Child(ren) $17.94 $55 $17.72

Employee + Spouse $16.60 $45 $18.04

Employee + Family $37.90 $80 $26.86


Insurance Rate

Allstate Cancer and Specified Disease
Insurance $20.34 - $107.10

TRS/Genworth Long-Term Care Insurance Visit www.trs.state.tx.us for rates.

Voya Short-Term Disability Insurance
• 3 Day Waiting Period $3.12 per $200 benefit
• 14 Day Waiting Period $2.06 per $200 benefit

Voya Optional Life Insurance
• Optional Employee Life Insurance $0.34 - $40.99 per $10,000
• Optional Spouse Life Insurance $0.37 - $10.26 per $10,000
• Optional Dependent Child Life Insurance $0.20 - $1.00 per $10,000

403(B) and Together Everyone

457(B) Tax


Sheltered

Savings Plan Achieves More!



All CCISD employees,
including substitutes Clear Creek Education Foundation
and temporary workers,
are eligible to enroll in a
Tax Sheltered Saving A monthly donation to the Clear Creek Education Foundation (CCEF)
Plan to supplement your makes a difference for our students and teachers. Your tax-
retirement. Contact TCG deductible donation provides innovative learning tools in the
Administrators at classroom, teacher grants, National Board Teacher Certifications,
1-800-943-9179 for and student tuition at Clear Horizons Early College High
403(b) and 457(b) School. Choosing to be a CCEF Cornerstone Club Member
enrollment information ($10/month) or Cornerstone Diamond Club Member ($20/month)
or visit the retirement gives you the added benefit of an extra jean day each month along
website at with a CCEF t-shirt ($10 monthly) or CCEF polo shirt ($20 monthly) to
www.tcgservices.com. wear on Foundation 1st Wednesday each month. ALL donations

make a difference. Thank you for your support!





JUST A CLICK AWAY...



















Aetna Accident Aetna Hospital Aetna Critical
Plan Indemnity Plan Illness Plan












CCISD Benefits Chard Snyder
Guide Direct Deposit
Form